| アブストラクト | BACKGROUND: Recent studies have demonstrated an association between high blood eosinophil counts and greater risk of asthma exacerbations. We sought to determine whether patients hospitalized for an asthma exacerbation were at greater risk of readmission if they had a high blood eosinophil count documented before the first hospitalization. METHODS: This historical cohort study drew on 2 years of medical record data (Clinical Practice Research Datalink with Hospital Episode Statistics linkage) of patients (aged >/=5 years) admitted to hospital in England for asthma, with recorded blood eosinophil count within 1 baseline year before admission. We analyzed the association between high blood eosinophil count (>/=0.35x109 cells/L) and readmission risk during 1 year of follow-up after hospital discharge, with adjustment for predefined, relevant confounders using forward selection. RESULTS: We identified 2,613 eligible patients with asthma-related admission, of median age 51 years (interquartile range, 36-69) and 76% women (1,997/2,613). Overall, 835/2,613 (32.0%) had a preadmission high blood eosinophil count. During the follow-up year, 130/2,613 patients (5.0%) were readmitted for asthma, including 55/835 (6.6%) with vs. 75/1,778 (4.2%) without high blood eosinophil count at baseline (adjusted hazard ratio [HR] 1.49; 95% CI 1.04-2.13, p = 0.029). The association was strongest in never-smokers (n = 1,296; HR 2.16, 95% CI 1.27-3.68, p = 0.005) and absent in current smokers (n = 547; HR 1.00, 95% CI 0.49-2.04, p = 0.997). CONCLUSIONS: A high blood eosinophil count in the year before an asthma-related hospitalization is associated with increased risk of readmission within the following year. These findings suggest that patients with asthma and preadmission high blood eosinophil count require careful follow-up, with treatment optimization, after discharge. |
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| ジャーナル名 | PloS one |
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| 投稿日 | 2018/7/26 |
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| 投稿者 | Kerkhof, Marjan; Tran, Trung N; van den Berge, Maarten; Brusselle, Guy G; Gopalan, Gokul; Jones, Rupert C M; Kocks, Janwillem W H; Menzies-Gow, Andrew; Nuevo, Javier; Pavord, Ian D; Rastogi, Sarang; Price, David B |
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| 組織名 | Observational & Pragmatic Research Institute Pte Ltd, Singapore, Singapore.;AstraZeneca, Gaithersburg, MD, United States of America.;University of Groningen, University Medical Center Groningen, Groningen,;Netherlands.;Ghent University Hospital, Ghent, Belgium.;The Peninsula College of Medicine and Dentistry, Plymouth, United Kingdom.;Royal Brompton and Harefield NHS Foundation Trust, London, United Kingdom.;AstraZeneca, Madrid, Spain.;Respiratory Medicine Unit and Oxford Respiratory NIHR BRC, Nuffield Department of;Medicine, University of Oxford, Oxford, United Kingdom.;Academic Primary Care, University of Aberdeen, Aberdeen, United Kingdom. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/30044863/ |
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